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A case/control study of paternal occupational exposure to lead (7439921) and the risk of spontaneous abortion was conducted. The cohort consisted of 213 spontaneous abortions occurring to Finnish females occurring during the period 1973 to 1983 identified from a national pregnancy registry and the central population register. The comparisons consisted of 300 normal births identified from the same registers. Occupational lead exposures of the husbands were determined from biological monitoring data of the Finnish Institute of Occupational Health and the central population register. The subjects completed a questionnaire to obtain information on demographic characteristics, occupational history, and pregnancy risk factors such as alcohol use and smoking. Paternal lead exposures in the cohort and comparisons were similar. Males employed in foundries and smelters had the highest exposures. Eleven cases and 11 comparisons had blood lead concentrations above the World Health Organization recommended standard for males, 1.9 micromoles per liter (micromol/l). Approximately 26.3% of the cases and 24.0% of the comparisons had blood lead concentrations above the Finnish standard for nonoccupationally exposed males, less than 1.0micromol/l. The overall risk of spontaneous abortion was not significantly associated with paternal blood lead concentration. A significant increase in spontaneous abortion risk of women whose husbands had blood lead concentrations of 1.5micromol/l or higher during spermatogenesis, the 80 day period before conception, was detected. Maternal age of under 27 interacted with paternal lead exposure to increase the spontaneous abortion risk. The risk was increased in wives of lead exposed spouses who consumed more than ten alcoholic drinks per week. Paternal age had no effect on abortion risk. The authors suggest that paternal lead exposure may be linked to the risk of spontaneous abortion in their wives. Paternal alcohol use and maternal age appear to interact with paternal lead exposure to increase the risk.